Fat-free Mass Index Research Articles

Somatization and Body Composition: Findings from a Cross-Sectional Study on Non-Clinical Young Adults

Background/Objectives: Lifestyle is a significant, common, and easily modifiable factor capable of increasing or reducing the risk of acquiring many diseases. Currently, there is a research gap as too little scientific attention has been focused on exploring the relationship between mental health and nutritional status in various populations. Moreover, the association between body composition and somatization has not been fully disclosed. Therefore, this study aimed to assess the associations of body composition with the symptomatology of somatization in an environmentally vulnerable sample of young adults. Methods: A single cross-sectional study included young non-clinical Lithuanian students (n = 1223) aged 21.7 ± 3.9. The body adiposity status of the study participants was estimated using both the body mass index (BMI) and the Body Adiposity Estimator (CUN-BAE) method. Fat-free mass was evaluated via the adjusted fat-free mass index equation (FFMIadj). The Patient Health Questionnaire (PHQ-15) was applied to assess the severity of the perceived symptoms of a somatic symptom disorder (SSD). Results: The CUN-BAE was considered to be a better predictor of adiposity than the BMI because 14.7% of females and 6.2% of males were interpreted as obese using the CUN-BAE, while the BMI equation identified participants as having a normal body weight. The highest rates of somatization were found in 18.6% of the cohort. Young adults with higher amounts of body fat mass (β: 0.050, 95% confidence interval (95% CI): 0.013; 0.084, p = 0.007) and lower FFMI are prone to a higher risk for developing somatization (β: −0.429, 95% CI: −0.597; −0.260, p < 0.001). Conclusions: Our study revealed that body composition is significantly related to multiple somatic complaints throughout a range of measurements. However, in contrast to the CUN-BAE tool, the BMI equation underestimated the relationship between body fat and mental health outcomes in young adults. Even though nutritional status along with targeted physical load, as the mediators, are likely to play a significant role in the maintenance of optimal body composition and mental health outcomes, healthcare providers are recommended to advise individuals to lower their body fat percentage and increase fat-free mass in order to reduce the risk of somatization.

Fat-Free Mass: Friend or Foe to Metabolic Health?

Fat mass (FM) and fat-free mass (FFM) are body composition estimates commonly reported in research studies and clinical settings. Recently, fat-free mass indexed to height (fat-free mass index; FFMI) has been shown to be positively associated with impaired insulin sensitivity or insulin resistance. Consequently, hypertrophic resistance training which can increase FFM was also questioned. This paper sets out to evaluate these propositions. In this narrative review, we discuss possible reasons that link FFMI to adverse metabolic health outcomes including the limitations of the body composition model that utilizes FFM. The safety of resistance training is also briefly discussed. Approximately 50% of FFM is comprised of skeletal muscle (SM), with the other 50% being viscera, skin, and bone; FFM and SM cannot be conflated. FFM and fat mass (FM) can both rise with increasing body weight and adiposity, indicating a positive correlation between the two compartments. Risk assessment models not adequately adjusting for this correlation may cause erroneous conclusions, however which way FM and FFM are indexed. Adipose tissue accumulation with weight gain, measured by dual-energy X-ray absorptiometry or bioelectrical impedance, can inflate FFM estimates owing to increased connective tissue. Increased adiposity can also result in fat deposition within skeletal muscle disrupting metabolic health. Importantly, non-skeletal muscle components of the FFM, i.e., the liver and pancreas, both critical in metabolic health, can also be negatively affected by the same lifestyle factors that impact SM. The most frequently used body composition techniques used to estimate FM and FFM cannot detect muscle, liver or pancreas fat infiltration. Prospective evidence demonstrates that resistance training is a safe and effective exercise modality across all ages, especially in older adults experiencing age- or disease-related declines in muscle health. The association between FFM and insulin resistance is largely an artefact driven by inadequate assessment of skeletal muscle. If FM and FFM are used, at the minimum, they need to be evaluated in context with one another. Body composition methods, such as magnetic resonance imaging, which measures skeletal muscle rather than fat-free mass, and adipose tissue as well as muscle ectopic fat, are preferred methods. Resistance training is important in achieving and maintaining good health across the lifespan. While strength and power are critical components of resistance training, the reduction of skeletal mass through ageing or disease may require hypertrophic training to mitigate and slow down the progression of this often-inevitable process.

The Essential Role of Right Amount and Quality of Protein for Ensuring Child Growth and Maintenance of Bone and Muscle Mass

Protein is a vital macronutrient, essential for growth, tissue repair, and immune function. However, the impact of elevated protein intake during childhood and adolescence remains controversial. While high protein intake in older adults is often recommended for maintaining muscle mass and preventing frailty, excessive intake in younger populations has raised concerns about potential health risks, particularly related to obesity. This review aims to update current literature on the long-term effects of protein consumption in children and adolescents (ages 4-18) and to explore emerging methods for evaluating protein metabolism in this age group. The RDA for protein varies based on age, sex, and activity level. Generally, it is suggested that children consume about 0.95-1.3 grams of protein per kilogram of body weight per day, depending on age and specific requirements. In many developed countries, children and adolescents often consume protein at levels 2-3 times higher than the RDA, potentially leading to both positive and negative health outcomes. Protein is critical for normal growth and development during childhood and adolescence. Adequate intake supports muscle development, immune function, and the production of hormones. Studies suggest that elevated protein intake may be linked to increased Fat-Free Mass Index (FFMI), which is beneficial for muscle development and overall body composition. High protein diets have been associated with increased satiety, which can help in managing appetite and potentially reducing overall caloric intake, thus contributing to healthier weight maintenance. Some evidence suggests a correlation between high protein intake in infancy and childhood and increased risk of obesity later in life. This association may be due to the overactivation of growth pathways and increased insulin-like growth factor-1 (IGF-1) levels. Excessive protein intake has been hypothesized to strain kidney function, especially in individuals with pre-existing kidney conditions. However, current evidence in healthy children and adolescents is inconclusive. This narrative review emphasizes the need for a nuanced understanding of protein intake in children and adolescents, considering both the benefits and potential risks associated with high protein consumption. As research evolves, dietary guidelines may need to be adjusted to reflect the latest findings.

P0271 Overweight is associated with low mediterranean diet adherence and increased disability in patients with Inflammatory Bowel Disease

Abstract Background The prevalence of obesity in inflammatory bowel disease (IBD) has risen, with 15–40% of adults classified as obese and an additional 20–40% as overweight1. Poor dietary habits and sedentary lifestyles contribute to overweight and sarcopenia, potentially worsening IBD-related disability. This study aimed to evaluate the relationships between nutritional status, adherence to the Mediterranean diet, sarcopenia and disability in IBD patients. Methods This cross-sectional study included consecutive IBD patients attending an outpatient clinic or infusion unit between 2023-2024. Bioelectrical impedance analysis (BIA) was used to estimate the fat-free mass index (FFMI), a recognized measure of skeletal muscle mass. Physical function was assessed via gait speed (time to walk 6 meters), and handgrip strength (HGS) measured using a Jamar dynamometer. Sarcopenia was diagnosed based on FFMI, HGS, and walking speed. Disability was evaluated using the IBD-Disk questionnaire, with scores ≥40 indicating moderate-to-severe disability. Adherence to the Mediterranean diet was assessed using the Medi-Lite score, with scores <9 reflecting low adherence. Demographic, clinical, and disease-related data were collected Results A total of 95 IBD patients (58% with Crohn’s disease, CD), 57.8% female, with a median age of 42 years (IQR 26-58) were included. Clinical activity ,measured with the Harvey-Bradshaw index (HBI) had a median score of 6 (IQR 4–7) for CD, while the median pMayo score for ulcerative colitis (UC) was 4 (IQR 2–6). The median BMI was 23.60 (IQR 21-27). Overweight prevalence was 43.2% (41/95). Low adherence to the Mediterranean diet was significantly more frequent in overweight patients compared to non-overweight patients (p<0.001). Overweight was also associated with increased age (p < 0.001). Sarcopenia prevalence was 7% (7/95) and was more common in non-overweight patients than in overweight patients (p = 0.002). The median BMI among sarcopenic patients was 20.6 (18.5–25.3). The mean IBD-Disk score was 41 ± 23.2, with 46.3% of patients reporting moderate-to-severe disability. Overweight patients were more likely to experience moderate-to-severe disability compared to non-overweight patients [27 (65.9%) vs. 23 (42.6%), p = 0.02]. No significant association was found between sarcopenia and moderate-to-severe disability (p = 0.44). Conclusion Overweight is associated with low adherence to the Mediterranean diet and increased disability in IBD patients. Targeted interventions to improve adherence to the Mediterranean diet and manage overweight could potentially reduce disability in IBD patients.

P0987 Muscle function deficits in Crohn’s Disease patients treated with Infliximab - tertiary single centre experience

Abstract Background Sarcopenia is an important consideration in the management of inflammatory bowel disease (IBD), in both prognosis and treatment. Since current data on sarcopenia in IBD are limited and based mostly on muscle quantity, it’s important to incorporate muscle function assessment into the evaluation of sarcopenia and to identify patient groups at increased risk. Methods A cross-sectional study included 84 Crohn’s Disease (CD) patients undergoing Infliximab therapy (64 males, mean age 34). Bioelectrical Impedance Analysis (InBody170) was done to estimate body composition parameters (BCP) which were then adjusted for height squared. Muscle strength was assessed by hand grip strength (HGS), measured using a dynamometer and muscle performance by gait speed test. Results Our results revealed that 6% of patients were underweight, 44% had normal body weight, 36.9% were overweight, and 13.2% obese. None of the patients exhibited low skeletal muscle mass index (SMI), however, half showed reduced muscle strength relative to age and sex adjusted norms in the general population. In relation to HGS, we found no significant differences in BCP, except for SMI (p=0.02) and body mass index (p=0.03), which were higher in patients with normal HGS. There were no differences between the groups in terms of physical activity levels, disease phenotype, prior surgeries, extraintestinal manifestations, clinical and endoscopic remission status. We observed significant differences in muscle quantity and quality based on disease localisation. Patients with ileocolonic CD had higher SMI (11.25±1.5 vs. 9.51±1.2 kg/m2, p=0.009) and HGS (41.1±6.6 vs. 31±6.7 kg, p=0.006) compared to those with colonic CD. Patients requiring biologic therapy due to immunosuppressive resistance had higher fat free mass index (19.4±2.4 vs. 18.2±3 kg/m2, p=0.05) and HGS (44.2 (24.9-45.3) vs. 39.3 kg (13.6-54.3), p=0.03), compared to patients on biologic therapy due to corticosteroid dependence or aggressive phenotype requiring top down approach. Patients diagnosed before 16 and after 40 years of age had lower gait speed (p=0.002), reflecting worse muscle performance. Conclusion Disease localisation, age at diagnosis and disease severity, as reflected by the indication for biologic therapy, may influence muscle composition and function. Our results emphasize the need for different and individualized management strategies based on disease localisation, especially in supporting muscle health among patients with isolated colonic CD and need for age-specific interventions, mainly in early and late onset CD, to support physical performance in these populations.

Development of an algorithm impacting COPD care through personalized nutrition and IoT-based monitoring

BackgroundChronic obstructive pulmonary disease (COPD) is a chronic respiratory condition characterized by high morbidity and mortality rates. This study aims to assess the clinical outcomes of COPD patients after implementing an algorithm within the MyTatva app.MethodsThe study involved a sample of 10 COPD patients, evaluating key parameters such as Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity, Weight, Body Mass Index (BMI), Fat-Free Mass Index, and Distance Covered during the 6-Minute Walk Test (6MWT) before and after the algorithm’s implementation in the MyTatva app. Patient satisfaction was assessed through a CSAT survey.ResultsFollowing the implementation of the MyTatva care plan, significant improvements were observed in several key clinical outcomes for COPD patients. FEV1 increased from a median of 3.24–2.0 L (p = 0.0379), while weight and BMI decreased significantly, with a reduction in weight from a median of 86–70 kg (p = 0.0007) and a corresponding decrease in BMI from 28.43 to 24 kg/m2 (p = 0.0031). The distance covered during the 6MWT also improved from 420 to 568 m (p = 0.0019). The participation of 10 COPD patients in surveys yielded an overall CSAT score of 85%, indicating a high level of satisfaction with the MyTatva app.ConclusionThe comprehensive features and functionalities of the MyTatva app, combined with the personalized care plan and real-time feedback mechanisms, have led to substantial clinical improvements in COPD management. These findings highlight the promise of this innovative digital therapeutic approach in addressing chronic respiratory conditions.

Sex-specific impacts of caffeine on body composition: commentary on a retrospective cohort study.

Understanding the impact of caffeine intake on body composition is a topic of growing research interest. The article "Association Between Caffeine Intake and Fat-Free Mass Index: A Retrospective Cohort Study" by Tian et al. explored this relationship, highlighting a positive correlation between caffeine consumption and fat-free mass index (FFMI). In this letter to the editor, we discuss the broader implications of these findings, emphasizing the need for further exploration of the underlying biological and lifestyle factors influencing caffeine's effects. To provide critical insights into the mechanisms and contextual factors that may explain the observed association between caffeine intake and FFMI, with particular focus on sex-specific differences, hormonal influences, and lifestyle interactions. This letter to editor builds on the findings of Tian et al., drawing from related literature and prior research to contextualize the potential mechanisms and broader implications of caffeine's impact on body composition. The discussion highlights key areas requiring further investigation, including the role of hormonal modulation, genetic variability, and long-term effects on muscle health. The positive association between caffeine intake and FFMI, particularly among women and younger populations, underscores the ergogenic potential of caffeine in enhancing muscle performance and metabolic efficiency. This letter expands on the study by emphasizing the role of hormonal factors, such as estrogen's modulation of CYP1A2, the liver enzyme critical for caffeine metabolism. The discussion also highlights the complex interplay between caffeine and other lifestyle factors. Finally, this commentary calls attention to the need for more research into the differential effects of caffeine sources, such as energy drinks and supplements, which often include additional ingredients with distinct metabolic and cardiovascular effects. These alternative sources may influence body composition differently than traditional coffee-based caffeine intake, an area that remains underexplored.

Plant-based dietary patterns, nutrient intake, growth, and body composition in childhood: Results from a prospective population-based study.

Transitioning to more plant-based diets promotes environmental sustainability and has health benefits for adults. However, associations with nutrient intake adequacy and growth in children remain unknown. This study aimed to examine associations of plant-based diets with nutrient intake levels among children, and with longitudinal growth and body composition up to adolescence. We included 3340 children in the Generation R Study, a population-based cohort. Food and nutrient intake were assessed at the age of 8 years, and anthropometrics and body composition (using dual-energy X-ray absorptiometry) were measured at the ages of 10 and 13 years. Plant-based diets were quantified using three plant-based diet indices (PDIs): overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). Modified Poisson regression and linear mixed models were used to estimate the associations of PDIs with nutrient intake levels, and with sex- and age-standardized measures of anthropometrics and body composition. Higher scores on each of the three PDIs were associated with lower intake of vitamin B2, B12, and calcium, while higher hPDI score was associated with higher intake levels of fiber, vitamin C, magnesium, and copper. Higher hPDI score was also associated with higher fat-free mass index (FFMI) z-score (0.05 per 10-hPDI score increment, 95% CI: 0.01, 0.10), and with lower body fat percentage z-score (-0.05, 95% CI:-0.09,-0.01), while higher uPDI score was associated with lower height, weight, and FFMI z-score (FFMI:-0.08, 95% CI:-0.12,-0.03) up to age of 13 years. In this cohort study, higher adherence to healthful plant-based diets, rather than unhealthful ones, was associated with better nutrient intakes, and subsequent healthy body composition throughout childhood to adolescence. Our findings suggest that consuming healthful plant-based foods may contribute to children's diets' nutrient quality and subsequent body composition. Still, attention should be given to ensuring balanced and adequate nutrient intake for optimal plant-based eating.

Body Composition Changes over a Collegiate Playing Career in NCAA Division I Women's Soccer Players.

Tinsley, GM, Meyer, MK, Ptak, SM, Yu, D, Provost, JA, Hansen, NJ, and Carbuhn, AF. Body composition changes over a collegiate playing career in NCAA Division I women's soccer players. J Strength Cond Res 39(1): e40-e55, 2025-Although body composition is known to influence success in organized sport, the longitudinal body composition changes produced by sport specialization are not well characterized for women's soccer. To address this need, this study reports the body composition changes of NCAA Division I women's soccer players over their entire collegiate playing career. Serial dual-energy x-ray absorptiometry (DXA) scans were performed throughout players' involvement in collegiate women's soccer. Analyses of all players with multiple DXA scans (n = 80) and players with ≥3 years of DXA data (n = 17) were performed using linear mixed-effects models that included effects of time, playing position, game minutes, and interactions. In all athletes (n = 80; 2.1 ± 1.2 years of participation), significant increases in bone mass (1.4%), total lean mass (1.7%), and fat-free mass index (0.3 kg·m-2) occurred. These changes coincided with increased arm and leg bone mass, increased lean mass in all regions, and decreased body fat percentage and leg fat mass. In athletes with ≥3 years of collegiate data (n = 17; 3.5 ± 0.4 years of participation), larger increases in bone mass (3.0%), bone mineral density (2.2%), total lean mass (2.5%), fat-free mass index (0.4 kg·m-2), and segmental bone and lean mass were observed. Larger decreases in body fat percentage and leg fat mass were also noted. Although playing position was related to body composition characteristics, changes in outcomes were generally unrelated to position or game minutes. In summary, beneficial changes in multiple aspects of body composition were observed over years of participation in a collegiate women's soccer program.

Association between handgrip strength and muscle mass in children 6 to 10 years old.

Sarcopenia, defined as a muscle mass loss and function, is increasingly recognized in pediatric populations, particularly in childhood obesity. Therefore, it is necessary to have measurements that can distinguish between muscle and fat mass. Methods of body composition such as Dual Energy X-ray Absorptiometry (DEXA) provide accurate assessments of body composition, but they are resource-intensive and impractical for routine monitoring in clinical or community settings. To address this, handgrip strength (HGS) may be used for assessing muscle mass. This study investigates the association between muscle mass and HGS in children aged 6-10 years. A cross-sectional study of 110 participants was conducted with children aged 6-10 years who could follow instructions in English, lay still for 6-7min, and had not entered puberty. Children with disabilities that affected muscle mass or hand strength were excluded. Height, weight, mid-upper arm circumference, lean body mass (LBM), fat mass (FM), fat-free mass (FFM), and bone mineral density (BMD) were measured. Pearson correlations between all body composition measurements and HGS were conducted. The best predictors of muscle mass were determined using stepwise analysis. A significant correlation between HGS and fat-free mass index (FFMI) (R=0.39) (p<0.001) among children aged 6-10 years and lean body mass index (LBMI) (R=0.42) (p=0.005) in children aged 8-10 years old was found. HGS with BMI (p<0.0001) were the best predictors of FFMI and LBMI. HGS was associated with muscle mass and may provide insight on body composition changes in children. Integrating HGS with BMI into routine clinical practice could enhance comprehensive evaluation of body composition.

Description of body image perception and its relation to nutrient intake in bodybuilders

Background: The problem of body dissatisfaction affects the perception of body image in bodybuilders. Objective: This study aims to determine the perception of body image and its relationship with nutrient intake in bodybuilders. Methods: A cross-sectional study was conducted involving 70 bodybuilders during the cutting phase of their training. Energy and nutrient intake data were collected through 24-hour Food Recall interviews for 2 days. Muscle mass and fat mass data were obtained by Bioelectrical Impedance Analysis (BIA). Body image perception data using the Bodybuilder Image Grid. Statistical analysis uses Spearman rank analysis. Results: Most bodybuilders were in early adulthood (aged 26-45 years), highly educated, employed in permanent jobs, and had incomes in the high category. The BMI was classified as normal, while the Fat-Free Mass Index (FFMI) in the competitive group was predominantly average, and in the non-competitive group, it was mostly below average. The group of non-competitive bodybuilders felt dissatisfied with their body shape based on fat mass and muscle mass, which was different from the group of competitive bodybuilders who felt satisfied with their body shape based on body fat mass It was found that carbohydrate intake was associated with body image perception, particularly in relation to fat mass (p&lt;0.01). Conclusions: Bodybuilders want a leaner body (low body fat mass percentage) and muscularity (high muscle mass percentage) by adopting a low carbohydrate and fluid diet.

Role of pulmonary rehabilitation in extracellular matrix protein expression in vastus lateralis muscle in atrophic and nonatrophic patients with COPD.

In response to exercise-based pulmonary rehabilitation (PR), the type of muscle fibre remodelling differs between COPD patients with peripheral muscle wasting (atrophic patients with COPD) and those without wasting (nonatrophic patients with COPD). Extracellular matrix (ECM) proteins are major constituents of the cell micro-environment steering cell behaviour and regeneration. We investigated whether the composition of ECM in atrophic compared to nonatrophic patients with COPD differs in response to PR. Vastus lateralis muscle biopsies from 29 male COPD patients (mean±sem forced expiratory volume in 1 s: 43±6% predicted) classified according to their fat-free mass index as atrophic (<17 kg·m-2, n=10) or nonatrophic (≥17 kg·m-2, n=19) were analysed before and after a 10-week PR programme for myofibre distribution and size, whereas a selection of ECM molecules was quantified using ELISA and real-time PCR. In nonatrophic patients with COPD PR was associated with increased myofibre type I distribution (by 6.6±2.3%) and cross-sectional area (CSA) (by 16.4±4.8%), whereas in atrophic patients with COPD, PR induced increased myofibre type IIa distribution (by 9.6±2.8%) and CSA (by 12.1±3.2%). PR induced diverse intramuscular ECM adaptations in atrophic compared to nonatrophic patients with COPD. Accordingly, following PR there was a significant increase in protein levels of ECM biomarkers (collagen type I by 90 pg·mL-1; collagen type IV by 120 pg·mL-1; decorin by 70 pg·mL-1) only in nonatrophic patients with COPD. Conversely, post-PR, osteopontin, a protein known for its dystrophic effects, and tenacin C, a necroptosis compensatory factor facilitating muscle regeneration, were upregulated at protein levels (by 280 pg·mL-1and 40 pg·mL-1, respectively) in atrophic patients with COPD, whereas fibronectin protein levels were decreased. These findings suggest that the differential PR-induced myofibre adaptations in atrophic compared to nonatrophic patients with COPD could be associated with inadequate remodelling of the intramuscular ECM environment.

Blood Circulating LncRNAs: SNHG5 and ZFAS1 as Biomarkers Reflecting Cachexia Incidence in Chronic Heart Failure Patients.

Systemic inflammation plays a crucial role in the development and progression of chronic heart failure (CHF) across all phenotypes. The continuous release of proinflammatory cytokines causes muscle atrophy and adipocyte breakdown, ultimately resulting in cachexia. Long noncoding RNAs (lncRNAs) are emerging as potential biomarkers associated with cachexia, as they indirectly regulate muscle and fat tissue metabolism. This study aimed to identify inflammatory-related, plasma-circulating lncRNAs characteristic of cachexia in patients with CHF. The secondary objective was to assess the clinical utility of these selected lncRNAs as diagnostic and predictive markers for cachexia. Blood plasma samples were collected from 157 newly diagnosed patients with CHF (91 males and 66 females; mean age: 72 ± 13 y) for lncRNA extraction. Molecular testing, using RT2 lncRNA qRT-PCR Array Human Cell Development, Differentiation, and Inflammatory Panel was performed in 2 phases: the discovery phase (screening of 148 lncRNAs in 8 patients) and validation phase (validation of the identified lncRNAs in 157 patients). Five lncRNAs were found to be differentially expressed in the discovery phase. In the validation phase, 2 of these 5 lncRNAs-SNHG5 and ZFAS1-showed significant expression differences between cachectic and noncachectic patients in the entire study group (both P < 0.001). The combined downregulation of ZFAS1 and upregulation of SNHG5 was identified as an unfavorable lncRNA signature primarily associated with poor nutritional status in females (low fat-free mass, fat-free mass index, and body mass index), abnormal laboratory results (hypoalbuminemia and high concentrations of inflammatory markers), and an increased incidence of cachexia in patients with CHF. When this lncRNA signature was combined with serum C-reactive protein and albumin concentrations, it effectively differentiated between cachectic and noncachectic patients (area under the curve = 1.0). The presence of this unfavorable signature was associated with a 9-fold increased likelihood (odds ratio = 9.2) of cachexia in the study cohort. The identified lncRNA signature demonstrates potential clinical value for distinguishing and predicting cachexia in patients with CHF.

Comparison between Global Leadership Initiative on Malnutrition criteria and protein-energy wasting in patients with kidney failure undergoing peritoneal dialysis.

Protein-energy wasting (PEW) is the chronic kidney disease (CKD)-specific diagnosis encompassing malnutrition. PEW is associated with adverse outcomes, including those receiving peritoneal dialysis (PD). Identifying PEW requires accurate methods to improve diagnosis. The Global Leadership Initiative on Malnutrition (GLIM) criteria is focused on validating a global consensus for malnutrition diagnosis in adults in clinical settings. While the GLIM criteria has been extensively studied in other clinical populations, there is limited evidence about the agreement with PEW in the PD setting. The aim of this study was to assess the agreement, accuracy, sensitivity, and specificity of GLIM criteria in comparison to the malnutrition inflammation score (MIS), a widely used tool to diagnose PEW in patients on dialysis. This was a cross-sectional study of patients undergoing PD. PEW was diagnosed using MIS score. Nutritional assessment was performed to identify malnutrition using GLIM criteria. Phenotypic criteria were assessed using low body mass index, low fat-free mass index, or low muscle strength. Etiology criteria were evaluated using high serum C-reactive protein or reduced food intake. The concordance between GLIM and MIS was evaluated by the Kappa test. A ROC-curve was used for identifying area under curve (AUC), sensitivity and specificity of GLIM. Patients undergoing PD (n=154) were included in the study. Participants had a median age of 40 (29-51) years and 46.7% were male. PEW/malnutrition was diagnosed using MIS score in 35.3% and in 27.3 % using the GLIM criteria. In comparison with MIS (used as the diagnostic reference), the sensitivity of GLIM was 65.8%, specificity 61.6 %, and AUC was 0.63. The weighted Kappa coefficient was (k 0.15, p=0.02.). GLIM criteria did not perform better than MIS in diagnosing PEW/malnutrition in patients in PD. Future research to assess the association of GLIM criteria with clinical outcomes is needed.

Osteocalcin in Infancy and Early Childhood and Its Correlation With Later Growth and Body Composition: A Longitudinal Birth Cohort Study.

Osteocalcin is a metabolic active hormone, which correlates positively with bone formation and inversely with body mass index and waist circumference in adults. To investigate whether osteocalcin in infancy and early childhood were related to childhood growth or body composition. A Swedish longitudinal birth cohort with blood samples from 551 children from birth until 5 years of age. Regular anthropometric measurements were carried out up to 8 years of age and dual-energy X-ray absorptiometry (DXA) scans were also performed at 8 years. The results included p-values and Spearman's rho (ρ). Osteocalcin at 4 months of age correlated inversely and consecutively with weight from 4 to 24 months and to waist circumference from 6 to 24 months in boys. The correlations for girls were limited to weight at 4 months and waist circumference at 6 and 18 months (ρ < 0.3, p = 0.001 to 0.048). The boys' osteocalcin levels at 5 years correlated positively with their height and weight at 5 and 6.5 years (ρ < 0.3, p < 0.01). Meanwhile, the girls' osteocalcin at 3 years showed positive correlations to all weight and height measurements until 8 years of age (ρ < 0.3, p = 0.003 to 0.023). DXA data showed that the boys' osteocalcin at 5 years correlated with the fat-free mass index (FFMI) (ρ 0.212, p = 0.026) but not the fat mass index (FMI) at 8 years. The opposite was seen for the girls' osteocalcin at 3 years, which correlated with FMI (ρ 0.222, p = 0.020) but not FFMI. Early levels of osteocalcin showed inverse correlations with later weight, height and body composition in infancy and positive correlations during childhood. The weak but consistent correlations suggest that osteocalcin carries information about future growth. Girls with high osteocalcin at 3 and 5 years had a larger fat mass at 8 years, while boys, in contrast, had a larger lean mass. These sex differences need to be further explored.

Development of Criteria for Assessing Nutritional Status in Moscow Adults Using Bioimpedance Analysis Data

Objective. To develop the criteria for assessing nutritional status in Moscow adults using bioimpedance analysis data.Materials and methods. The research used data from a non-clinical, cross-sectional, observational study on the body composition of Moscow adults aged 18-96 in Moscow health centers between 2010 and 2019 by the method of bioimpedance analysis. A total of 340,814 persons were assessed, including 96,780 men and 244,034 women. Bioimpedance measurements were taken using bioimpedance analyzers according to a standard four-electrode assessment scheme in the supine position of patients with disposable bioadhesive ECG-electrodes. The relative fat mass (RFM) was assessed using the percentage of fat mass (%FM) and the fat mass index (FMI). The criteria for assessing RFM were the cut-offs of %FM and FMI calculated based on the centiles of BMI thresholds according to the IOTF ageand sex-specific criteria. Polynomial smoothing was then applied. In the same way, the criteria for assessing the relative fat-free mass (RFFM) were derived based on the cut-offs of the fat-free mass index (FFMI).Results. Diagnostic tables were designed to determine the RFM and RFFM in Moscow adults. The prevalence of normal weight obesity was assessed.Conclusion. In conjunction with the previously developed criteria for assessing the nutritional status of Moscow children and adolescents, the study results can be used in clinical, preventive, or sports medicine to diagnose and correct nutritional status disorders as well as to monitor physical development.

Development of Criteria for Assessing Nutritional Status in Moscow Children and Adolescents Using Bioimpedance Analysis Data

Background. Body composition assessment plays an important role in characterizing physical development, monitoring health status, diagnosing nutritional disorders, and assessing disease risks.Objective. To develop the criteria for assessing nutritional status in Moscow children and adolescents using bioimpedance analysis data.Materials and methods. The research used data from a non-clinical, cross-sectional, observational study on the body composition of children and adolescents aged 5–17 in Moscow health centers from 2010 to 2019 by the method of bioimpedance analysis. A total of 115,200 persons were assessed, including 61,430 boys and 53,770 girls. Bioimpedance measurements were taken using bioimpedance analyzers according to a standard four-electrode assessment scheme in the supine position with disposable bioadhesive ECG-electrodes placed on the patient’s wrists and ankles. The relative fat mass (RFM) was assessed using the percentage of fat mass (%FM) and the fat mass index (FMI). The criteria for assessing RFM were the cut-offs of %FM and FMI calculated based on the centiles of BMI thresholds according to the IOTF ageand sex-specific criteria. Polynomial smoothing was then applied. In the same way, the criteria for assessing the relative fat-free mass (RFFM) were derived based on the cut-offs of the fat-free mass index (FFMI).Findings. Diagnostic tables were designed to determine the RFM and RFFM in Moscow children and adolescents. The prevalence of normal weight obesity was assessed.Conclusion. The study results can be used in clinical, preventive, or sports medicine to diagnose and correct nutritional status disorders as well as to monitor physical development.

Multicomponent body composition of university club sport athletes.

The body composition of National Collegiate Athletic Association (NCAA) athletes is well documented but no such data exist for university club sports athletes. Additionally, the majority of norms for NCAA athletes were created from individual methods requiring assumptions. This study used a four-component (4C) model to measure the body composition of university club sports athletes. Data were collected on club athletes participating in baseball, climbing, cycling, figure skating, gymnastics, ice hockey, lacrosse, pickleball, powerlifting, racquetball, rodeo, rugby, soccer, swimming, ultimate, and volleyball. The 4C model consisted of body volume, total body water, and bone mineral content measured by air displacement plethysmography, bioimpedance spectroscopy, and dual-energy x-ray absorptiometry, respectively. Percentile ranks were created for body fat percentage (%BF) and fat-free mass index (FFMI). Mean differences across teams were quantified with Cohen's d. In total, 225 athletes (137 men, 88 women) completed data collection. Athletes varied in competitive experience (1 to 22 y) and body mass index (16.9 to 36.4 kg·m-2). The density of the FFM was significantly greater than the assumed value of 1.100 g·cm-3 for both men (p = .043) and women (p = .011). The %BF ranged from 4.9% to 35.7% (14.3 ± 5.8% BF) for men and from 15.5% to 42.8% (25.2 ± 6.0% BF) for women. FFMI ranged from 15.6 kg·m-2 to 26.8 kg·m-2 (30.0 kg·m-2 outlier removed) for men and from 14.1 kg·m-2 to 22.6 kg·m-2 for women. Differences across sports in %BF and FFMI were considered large-sized effects (d ≥ 0.80) for both men and women. Weight-sensitive sports (e.g. cycling and climbing) had the lightest athletes and were among the leanest, whereas power athletes (e.g. powerlifting and rugby) were among the heaviest athletes and had the highest FFMI. Differences in %BF and FFMI are evident across sports. Due to the small sample size, use caution when interpreting the data as reference values for club sports athletes.

Prevalence and associated body composition factors of sarcopenia in community-dwelling older adults

BackgroundThe objective of this investigation was to examine the frequency and determinants related to body composition of sarcopenia among aging individuals residing in the Beijing community through implementation of the diagnostic criteria for sarcopenia outlined by the 2019 Asian Working Group for Sarcopenia (AWGS).MethodsA cross-sectional examination employing multistage cluster sampling was conducted on a sample consisting of 933 individuals aged 50 years or above. The study utilized the AWGS 2019 criteria for muscle mass, muscle strength, and physical function to gauge sarcopenia. In addition, data on demographic characteristics, anthropometry, and body composition were collected. Logistic regression analysis was carried out to ascertain the relationships between sarcopenia and correlated factors.ResultsThe study found that the overall prevalence of sarcopenia was 8.3%. Sex (p < 0.001) and body mass index (BMI p < 0.001) were determined to have a significant association with the occurrence of sarcopenia. The adjusted analyses demonstrated that with each standard deviation increase in fat-free mass index (OR = 0.02 (0.01–0.05), of 95%), skeletal muscle mass (OR = 0.17 (0.12–0.25), of 95%), and other body composition indicators (including total body water 0.26 (0.2–0.35), intracellular water 0.1 (0.06–0.17), protein 0.01 (0–0.02), soft lean mass 0.35 (0.28–0.44), BMI 0.58 (0.51–0.67), body cell mass 0.21 (0.15–0.29), OR < 0.60, of 95%), the risk of sarcopenia decreased by more than 40%. Certain straightforwardly accessible anthropometric indices such as upper arm circumference (correlation coefficient 0.94 (0.9–0.97), 0.97 (0.95–1), 1.01 (0.99–1.03), respectively, of 95%), waist circumference (0.94(0.92–0.96), 1.01 (0.99–1.03), 1.02 (1–1.03), of 95%), hip circumference (0.93 (0.9–0.96), 0.99 (0.97–1.02), 1.02 (1–1.04), of 95%), waist-to-hip ratio (0.93 (0.87–1), 1.04 (1–1.08), 1 (0.97–1.03), of 95%), body fat percentage (1 (0.98–1.02), 1.02(1–1.04), 1.01 (0.99–1.02), of 95%), and phase angle (0.91 (0.89–0.93), 0.96 (0.94–0.98), 0.99 (0.98–1), of 95%) exhibited substantial correlation with skeletal muscle index, muscle strength or physical performance. However, no noteworthy link between sarcopenia and most variables associated with physical function was discovered.ConclusionsThe findings of the study highlight the prevalence of sarcopenia among the aging residents of Beijing. Certain easily measured anthropometric indices demonstrated strong correlation with muscle strength or physical performance, thereby providing an avenue for screening and diagnosing sarcopenia in older people who may not be able to undergo grip strength or physical function assessments. To investigate causal relationships, future studies employing longitudinal or interventional designs with a more comprehensive population are warranted.

Impact of Early Life Famine Exposure on Body Composition and Metabolic Profiles in Adulthood.

The relationship between the famine and metabolic syndrome has been reported, but there is a lack of more detailed changes in metabolic profiles. It is unclear how famine affects body composition. This study included 21,142 participants from the China National Health Survey. The body mass index (BMI), fat mass index (FMI), and fat-free mass index (FFMI) were calculated. Systolic blood pressure (SBP), diastolic blood pressure (DBP), blood lipids, and fasting blood glucose (FBG) were measured. Multivariate adjusted linear regression models were used to assess the association between famine and outcome. Our results shown that fetal-exposed group had higher BMI and FMI (β > 0). Childhood-exposed group showed an average decrease of 0.08 standard deviation (SD) in FFMI, and adolescence-exposed group had lower BMI and FFMI than non-exposed group. SBP were 0.38 SD higher in fetal-exposed group, 0.58 SD higher in childhood-exposed group and 0.85 SD higher in adolescence-exposed group than non-exposed group. Famine-exposed groups had higher total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), and FBG levels (β > 0). For females with famine exposure, they had a higher BMI, FMI, LDL-C, TG, and TC than males. Overall, early famine exposure is associated with increased blood pressure, LDL-C, TC, and FBG. Muscle mass loss in adulthood associated with childhood and adolescence famine exposure. Famine-exposed females appear to have higher levels of body fat and blood lipids.